Median nerve and carpal tunnel volume changes after two different surgical methods: A comparative magnetic resonance imaging study of mini-open and endoscopic carpal tunnel release
Nazmi Bülent Alp1, Gökhan Akdağ2, Aslı Ceren Macunluoğlu3
1Department of Orthopedics and Traumatology, Istanbul Bahçelievler State Hospital, Istanbul, Turkey
2Department of Orthopedics and Traumatology, Beylikdüzü State Hospital, Istanbul, Turkey
3Department of Biostatistics, Uludağ University, Institute of Health Sciences, Bursa, Turkey
Keywords: Carpal tunnel syndrome, carpal tunnel volume, endoscopic release, median nerve volume, transverse carpal ligament, volume expansion.
Objectives: This study aims to compare endoscopic carpal tunnel release versus mini-open carpal tunnel release regarding volume changes in the carpal tunnel and median nerve by magnetic resonance imaging (MRI).
Patients and methods: The study included 17 wrists of 13 patients (1 male, 12 females; mean age 55 years; range, 51 to 64 years) who were diagnosed with carpal syndrome. Ten wrists underwent mini-open carpal tunnel release, while seven wrists underwent uni-portal endoscopic carpal tunnel release. Carpal tunnel and median nerve volumetric changes were evaluated by MRI pre- and postoperatively.
Results: Surgical section of transverse carpal ligament significantly increased the postoperative volume of the carpal tunnel and median nerve compared to preoperative (p<0.05). However, the endoscopic and mini-open carpal tunnel techniques had no superiority over one another regarding volume expansion (p>0.05).
Conclusion: Both methods can be preferred to release the transverse carpal ligament in patients with idiopathic carpal tunnel syndrome. The surgeon should decide on which method to use considering the advantages and disadvantages reported in the literature.